Developing the dimpled skin of cellulite seems practically inevitable if you’re a woman — no matter how thin you are. It doesn’t seem to discriminate based on body type.

But what is cellulite? Is it the same as fat? Even though it is common, you may not want to just surrender and live with it.

Dermatologist Shilpi Khetarpal, MD, answers questions about cellulite and what you can do about it.

Q: What is cellulite?

A: You may think cellulite relates to how much fat you have, but we see cellulite in people who are thin, normal weight and overweight.

We all have fat cells in compartments beneath the skin that grow over time due to hormones, lifestyle and diet. As this occurs, tough, fibrous cords that connect your skin to your muscles pull downward on the skin as the fat pushes upward. This creates an uneven, dimpled surface.

 This puckered and dimpled skin shows up most commonly on the thighs, hips and buttocks.

Q: Are certain people more likely to have cellulite?

A: We know that age, heredity and lifestyle choices can predispose someone to getting cellulite.

You are more likely to have it if:

• Someone in your family has it
• You are older (your skin loses elasticity as you age, making surface changes more visible)
• You’ve had a baby or gone through puberty (estrogen is thought to play a role)
• You have a sedentary lifestyle
• You eat an unhealthy diet high in fats and carbohydrates

Less than 10 percent of men have cellulite. Men’s fibrous tissue is stronger and structured so that it is more likely to hold fat in rather than push it toward the surface. Men also have testosterone, which helps limit body fat; women have estrogen, which helps store fat.

Q: Can you avoid cellulite with lifestyle changes?

A: Nothing you do can guarantee that you won’t get cellulite. But there are things that may help you avoid or limit it:

• Get regular exercise.
• Avoid processed foods.
• Avoid foods that are high in fat and refined sugars.

Q: Do creams and spa treatments that claim to get rid of cellulite work?

A: There is no magic answer to cellulite. Once it’s there, it’s difficult to get rid of. It doesn’t always respond well even if you adjust your diet or get more exercise.

There is no scientific proof that the creams on the market work. In fact, some have ingredients that can cause adverse skin reactions — so use caution if you decide to try them.

Some spas offer vigorous massage in areas where you have cellulite. This can increase blood flow and reduce excess fluid. These massages may help, but the improvements won’t last. Most at-home therapies and spa treatments only make you look better for several hours after treatment.

Q: Are there any permanent solutions?

A: Not permanent, no. But there are minimally invasive or surgical interventions that aim to eliminate the fibrous cords pulling down on the skin.

The Food and Drug Administration has approved a few, including Cellfina™ and Cellulaze™. The results of these procedures have been shown to last for more than three years.

It’s important to do your homework if you are considering one of these longer-lasting solutions. Talk to your doctor or dermatologist and investigate your options, including those that are FDA-approved.